The debris strewn along the coastal neighborhoods of Minamisoma should be proof enough of the devastation wrought by the tsunami that hit Japan's north-east coast on 11 March. But for the past month this sprawling town in Fukushima prefecture has been confronted by a second, more insidious threat: radiation.

Minamisoma is a town living in a state of nuclear limbo. Its southern reaches lie just inside the 20km (12 mile) radius from the Fukushima Daiichi nuclear power plant that has been declared an evacuation zone. Farther north, residents have been told to remain indoors or consider leaving. Thenon Tuesday the government announced that five additional communities, possibly including more neighborhoods inside Minamisoma, are to be included in an expanded evacuation zone amid fears over the long-term effects of radiation seeping from the Fukushima plant.

Even before that advice was issued, the majority of Minamisoma's 71,000 people had voted with their feet. The first hydrogen explosion at the plant prompted an exodus that saw the population plummet to just 10,000.

Petrified residents barely had time to mourn the 1,470 local people listed as dead or missing before abandoning their homes.

Shops and restaurants closed, suppliers refused to enter the town, and for a few chaotic days the only vehicles on the streets were self-defense force trucks and dozens of buses laid on to take evacuees to hundreds of temporary shelters across Japan.

The government's chief spokesman, Yukio Edano, said the crisis had not caused any direct damage to the health of people living near the plant. "The accident itself is very serious, but we have set our priorities so as to avoid damage to people's health."

His claim is backed by a recent radiation reading in Minamisoma that measured 0.9 microsieverts per hour - or 7,884 microsieverts per year - which is little more than that received in a chest CT scan and, say experts, poses no immediate threat to health.

But the new evacuation plans have added a layer of uncertainty to a community already gripped by fear.

Some residents who initially evacuated are now returning to the area, reassured by data showing that radiation is well below dangerous levels.

At a local health center medical workers in protective clothing offer free radiation checks for residents and visitors.

"People here are already traumatized by memories of the tsunami and the struggle to survive the nuclear crisis," said Kyohei Takahashi, a gynecologist who initially left Minamisoma but returned a few days later.

He came back to find patients deprived of essential care and hospitals emptied of staff. "At the start we had no food or medicine – we couldn't even administer intravenous drips," said Takahashi, 72.

"At first the streets were dead. But now there are a few cars on the road and some shops have reopened. Radiation levels are very low, but people are still anxious about the future.

"It could be months before things settle down. Until then, all I can do is my job. If we all work together we can make something of this town, even if it takes years. But it will never be the same again."

The emergency at Fukushima Daiichi, now rated on a par with the Chernobyl disaster in its severity, has split the community he serves.

Yoshitaka Okawa, who has worked for a subcontractor at the plant for 19 years, is one of the few residents who have remained in the city throughout the crisis. He loses sleep not over radiation, but over the friendships that he fears may have been irreparably damaged by his pleas to neighbors not to abandon the town of his birth.

"I've been working at Fukushima Daiichi for almost two decades. I know all about millisieverts and microsieverts [of radiation], and I have never considered leaving," says the 60-year-old, an employee of a firm that decontaminates nuclear plant workers.

Okawa has not been back to the plant since 11 March, when he fled the No 5 reactor building following the 9.0-magnitude earthquake. "I'm due to retire, so I won't be going back. As things are, I couldn't even if I wanted to.

"But other people in the town don't think rationally. When the media report that radiation is several thousand times above legal limits, they panic.

"The people I feel sorry for are farmers whose lives have been ruined by radiation scares, and the old people who have been unable to leave. When I see people in Tokyo panic-buying water or choosing not to buy certain produce, I wonder if they have any feelings for fellow Japanese who are genuinely in need of help."

Minamisoma's plight drew worldwide attention last week after its mayor, Katsunobu Sakurai, pleaded for help in an 11-minute YouTube video with English subtitles.

"We are left isolated," said a clearly exhausted Sakurai, dressed in his familiar crisis uniform. "I beg you, as the mayor of Minamisoma, to help us."

The town's commercial infrastructure, he said, lies in tatters. "The only places open are local banks and credit unions," he said in an interview with the Mainichi Daily News. "The supermarkets are still not running. There are no daily supplies that people living here desperately need.

"If the city doesn't maintain its essential services, evacuated residents won't know which way to turn. The government must do all it can to address the nuclear accident and give us an idea of when it will be resolved."

But as Japan's prime minister Naoto Kan has acknowledged, it is a question to which no one knows the answer.

And for all his optimism over the radiation threat, Okawa concedes that the unease it has generated has changed Minamisoma beyond recognition.

"As long as the power plant is in trouble, this town might as well be dead. You walk to the station and everything is shuttered. At night the streets are dark and empty. This used to be a fun, lively place to live. But not any more."

Further

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